Officials said too many teachers were using the expensive drugs for recreation, swelling their insurance rates. An estimated 1,000 of the 10,000 school's staff, which includes employees, dependents and retirees, were using the drugs.

Now, teachers are fighting to get the benefit back with a lawsuit. The Milwaukee Teachers' Education Association (MTEA) argues that the new policy discriminates unfairly against men and "creates barriers" to receiving necessary medical treatment.

In recent years, several lawsuits have claimed that health plans discriminate against women by not providing contraceptives, but now medications like Viagra -- which can cost $20 a pill -- are being viewed as so-called "lifestyle" drugs.

Drug companies have invested more than $20 billion in research into drugs like weight loss pills, smoking cessation medications, hair restoration products and erectile dysfunction drugs since the 1990s, according to the scientific journal Nature.

But as budgets tighten, federally funded programs like Medicare are dropping their coverage of these expensive drugs and some employers are following suit.

In 2002, Milwaukee's school district agreed to cover six tablets a month. But when the bill skyrocketed to $207,000, the benefit was ended in 2005.

Kris Collett, spokesman for the MTEA, said the union had filed a complaint with the Wisconsin Equal Rights Division in 2008, but it was dismissed on procedural grounds in 2009. Now, the union has appealed to the Labor and Industry Review Commission to go forward with the lawsuit.

"The health plan provides medications to women for similar medical conditions, but men are excluded from pharmacy treatment," said Collett, referring to insurance coverage for female sexual dysfunction treatments like vaginal creams, estrogen and anti-bacterial medicine.

The health plan still covers options such as penile pumps and implants, but the union says they are "far less desirable than oral medication," according to the filing.

As sparks fly, even a union-endorsed gubernatorial candidate is getting into the fray. Democrat Tom Barrett, whose wife lost her job as a teacher, has asked the union to drop the lawsuit.

Viagra for Recreation, Not Medicine

"I know you agree there are fewer issues more important to the future of our communities and our state than the education of our children," wrote Barrett in a letter to the MTEA this week. "In tough budgetary times, it's even more essential that we invest our precious education resources wisely."

"As governor I will work to invest more resources to strengthen education in Wisconsin," he wrote. "However, I believe education dollars should be devoted to enhance performance in the classroom."

"The reality is that in other places across the country, millions of school districts are facing enormous budget crunches," said Phil Walzak, spokesman for the Barrett campaign. "Here we have a situation in Milwaukee where 490 teachers were laid off recently causing constraints."

Although 89 teachers were reinstated, "it impacts what happens in the classroom and individual attention for students," he said. "We have seen increasing property tax rates in the past several years. When they saw the costs, one has to reconsider."

"These drugs were identified as recreational, as opposed to a medical necessity," said Walzak.

But other men take exception. Texas divorcee Paul Franco said the erectile dysfunction drug Levitra saved his mental health. Ten years ago, as a stressed-out car salesman, he had difficulty performing.

"I was wondering why I can't have an erection with my wife," said Franco, a father of five. "I have a beautiful wife."

Now, his insurance covers his Levitra and he has a girlfriend. 'I feel great," said Franco, who now sells insurance. "I feel 100 percent better."

Franco said he cannot understand why Milwaukee teachers can't have the same benefit, especially considering the stress they face daily in the classroom.

Why Can't Stressed Teachers Get Benefit of Viagra?

"It definitely sounds unfair to me because of the male teachers," he said. "You hear about a lot of stuff going on in school these days. I bet you have a bunch of teachers where the marriages go wrong. Having a sexless marriage doesn't work at all."

"The underlying principle is if you want something covered and it's not outright harmful, typically it's covered, if the purchaser is willing to pay for it," she said.

State laws vary in what coverage they can mandate -- emergency room care, for example -- and the new federal health care law will also determine new requirements. Even prescription drug coverage is not universally required by law.

"Some employers purchase a health plan more or less off the shelf, and others want to have something more tailored to their needs," said Pisano. "Where there is not a state law, the employer's decision plays heavily into it."

How many in a group plan use a prescription drug can affect the employer's costs.

"It may be that a drug for a very rare disease costs a lot of money and is not used that much and something less expensive is used more extensively," she said. "Drug costs are going to keep going up and hospitals, doctors and employers are going to face tough choices."

"Look at demographics of our society," said Dr. Robert Davis, clinical professor of urology at the University of Rochester Medical Center. "Erectile dysfunction goes with hypertension, diabetes, metabolic syndrome with a waist over 40 inches in men and high cholesterol. There is an obesity crisis in this country and a third of Americans are overweight."

As for those who may use these drugs recreationally, Davis said doctors have no way of knowing whose claim is legitimate -- and he said the school district probably does not either.

The Viagra Wars: Milwaukee Teachers Fight for Insurance Coverage

"I don't knowingly prescribe them that way, but patients can present stories and manipulate us," Davis said. "We have no truth serum and have to accept stories as they are related."

Some pharmaceutical-funded studies have shown Viagra is effective for treating depression, according to Davis.

"People who can't sexually function often lose their self esteem and a part of life they value and regain with Viagra," he said.

Such was the case with Charles, a 41-year-old from Alaska, who did not want his last name used. He said he uses these drugs and they "work very well."

"I believe health insurance should cover the cost of Viagra because when you are unable to get an erection your confidence is destroyed, you are unhappy and depressed, which will lead to more health risk," he wrote ABCNews.com. "It has been proven that a happy person is a healthier person. Saving the money will make you even more happy."

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